2020 Volume 62 Issue 8 Pages 1487-1493
We experienced a case of colonoscopic release of adult intussusception that was due to cecal cancer which was subsequently treated using elective laparoscopic surgery. An 81-year-old woman being treated for upper abdominal pain at our hospital was found to have a target sign in the ascending colon on computed tomography (CT). Enhanced CT showed multiple concentric ring signs and local colon-wall thickening, which were diagnosed as tumor-induced intussusception. Colonoscopy showed an elevated lesion in the cecum, and histological findings of a biopsy specimen from the lesion showed mucinous adenocarcinoma. Intussusception was easily reduced using air injection. Three days after intussusception repositioning, laparoscopic ileocecal resection with lymph node dissection was conducted using five trocars. Examination of the resected specimen revealed a type 1 tumor in the cecum measuring 22×27mm. Pathologically, the tumor was a mucinous adenocarcinoma type1 pMP in depth, ly1, v1, and pN0. The patient had an uncomplicated postoperative course and was discharged 11 days after surgery. Adult intussusception is rare. Most cases of adult intussusception caused by a tumorous lesion tend to be treated by emergency surgery without a definitive diagnosis. Preoperative reduction, if possible, may be important for preoperative diagnosis and appropriate surgical treatment. We reviewed 16 such cases in the Japanese literature, including our own, that were treated using laparoscopic surgery.
